Healthcare Provider Details

I. General information

NPI: 1902032279
Provider Name (Legal Business Name): NATUROPATHIC INTEGRATIVE FAMILY HEALTHCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 06/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2769 W BROADWAY
EAGLE ROCK CA
90041-1038
US

IV. Provider business mailing address

2769 W BROADWAY
EAGLE ROCK CA
90041-1038
US

V. Phone/Fax

Practice location:
  • Phone: 818-484-5185
  • Fax: 323-256-6446
Mailing address:
  • Phone: 818-484-5185
  • Fax: 323-256-6446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberND-301
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberND-301
License Number StateCA

VIII. Authorized Official

Name: DR. MICAELA R FINLAYSON
Title or Position: CEO-PRESIDENT
Credential: ND
Phone: 818-484-5185